Brand Name | BARD PER FIX PLUG WAS PUT IN ME ON AUGUST 10TH 2015 ( WHEN IT WAS RECALLED) |
Type of Device | MESH, SURGICAL, POLYMERIC |
Manufacturer (Section D) |
DAVOL INC., SUB. C.R. BARD, INC. |
|
|
MDR Report Key | 13783108 |
MDR Text Key | 287393605 |
Report Number | MW5108183 |
Device Sequence Number | 1 |
Product Code |
FTL
|
Combination Product (y/n) | N |
Reporter Country Code | US |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Voluntary
|
Reporter Occupation |
Patient
|
Type of Report
| Initial |
Report Date |
03/14/2022 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Date FDA Received | 03/15/2022 |
Is this an Adverse Event Report? |
Yes
|
Is this a Product Problem Report? |
Yes
|
Was Device Available for Evaluation? |
No
|
Patient Sequence Number | 1 |
Treatment | ATORVASTATIN; VITAMIN D3 |
Patient Outcome(s) |
Disability;
Other;
Life Threatening;
|
Patient Age | 61 YR |
Patient Sex | Male |
Patient Weight | 73 KG |
Patient Ethnicity | Non Hispanic |
Patient Race | White |
|
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